


Report: The Vesuvian Red Plague

by magicbeanbuyer



Category: The Arcana (Visual Novel)
Genre: Blood, Fake Science, Gen, Medical Jargon, References to Illness, description of plague symptoms
Language: English
Status: Completed
Published: 2019-07-05
Updated: 2019-07-05
Packaged: 2020-06-09 15:10:03
Rating: Teen And Up Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 1,096
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/19478464
Author URL: https://archiveofourown.org/users/magicbeanbuyer/pseuds/magicbeanbuyer
Summary: A report on the symptoms and treatment of the Red Plague in Vesuvia, written by Dr. Ilya "Julian" Devorak and published in an emergency issue of the Vesuvian Royal Medical Society Journal.





	Report: The Vesuvian Red Plague

##  Overview 

Vesuvia's Red Plague is unlike any disease that I have encountered in the past, both in the severity of its symptoms and the relative speed at which it spreads. As of this report, I have treated sixty-two (62) cases of the Red Plague in the past six months, all of which were fatal. The plague does not seem to discriminate based on sex, as the sex breakdown of my patients has been consistent with that of the general population. My patients have ranged from infancy to 97 years of age, with no clear distinction between age groups except for a slightly quicker progression among children and older adults. 

The median amount of time spent in the latter three stages of the plague is 15 days, although some patients have survived for as little as 4 days or as long as 44 days. 1

I have compiled my findings into the following report. 

##  Symptoms 

### Stage 1: Early Warning Signs

A healthy person experiencing unexplained **malaise** , low-grade **fever** , **chills** , or **watering eyes** may be developing the plague. Perhaps early treatment could help prevent death at this stage, although because symptoms in this stage are so subtle, I have never actually treated a patient in this stage. My findings in this section are based entirely on the testimony of patients who have sought treatment in later stages. Most patients would rate their overall pain/discomfort level during this stage as a 1 or a 2 on a scale of 1 to 10. Some people (45% of those reporting this stage) notice a slightly **red flush to the skin** during this stage. Towards the tail end of this stage, **sclera may or may not begin to turn pink** , although once sclera are fully red, the plague has moved decisively into stage 2. 

Based on accounts from patients that I have treated, this stage lasts for about 1 to 3 days, if it is reported at all.

### Stage 2: Red Sclera 

The first indication of plague that most people notice are the tell-tale **red sclera** . These are generally accompanied by **mild headaches** and a **slight cough** . The cough may or may not be productive, but **no blood is seen in sputum in this stage** . Most patients (88%) report **large sores resembling insect bites on the limbs.** It is unclear whether these develop during Stage 1 or Stage 2, but they generally fade by the end of this stage. The fever, chills, and watery eyes from Stage one continue and worsen during this stage. For most patients, pain and discomfort ranges from 1 to 3 on a scale of 1-10.

This stage generally lasts 3 to 5 days. 2% of patients die during Stage 2, generally very young or very old patients.

### Stage 3: Coughing Blood

Symptoms severely worsen between stages 2 and 3. The most prominent indicator that patient has moved into the third stage of the illness is that the **cough produces blood** . All symptoms that were present during Stage 2 persist and worsen during Stage 3. **Pain is markedly increased** in this stage, with most patients rating their overall pain level between a 5 and 8. Many patients (68%) experience **delirium** , although it is unclear whether this is a symptom in of itself or if it is merely a byproduct of the severe pain that patients endure during this stage. Some patients (26%) experience **nausea**. Nausea in this stage is highly correlated with vomiting in Stage 4: 84% of patients who survived into Stage 4 and reported nausea during Stage 3 also reported vomiting in Stage 4. 

Stage 3 generally lasts for six to ten (6-10) days. Approximately **77% of patients die in Stage 3.** Patients who linger in Stage 3 for more than seven (7) days are more likely to die before the disease progresses to Stage 4, although this is not always the case. 

### Stage 4: Bleeding from the Eyes 

Progression into Stage 4 is marked by **bleeding from the eyes** . Patients will occasionally (11%) **bleed from other orifices** such as the mouth, nose, or ears. Most patients (76%) report **spontaneous bruising,** particularly on the arms, legs, armpits, and groin. Some patients (21%) **vomit blood** . Nearly all (93%) patients experience some degree of **sanity loss** , including but not limited to **auditory and visual hallucinations**. Patients generally rate their pain levels between 9 and 10 during this stage. 

Stage 4 lasts for 3 to 5 days. **All patients who survive to Stage 4 ultimately succumb to the illness.**

##  Prevention 

My current hypothesis is that plague is **spread through water** as well as through **contact with bodily fluids, particularly blood.** I believe that blood is the key to understanding the plague, as most of the symptoms are related to the blood. Therefore it is imperative that people in close quarters with plague victims, particularly physicians, take precautions to limit their contact with the patient's blood. I recommend a **minimum uniform of a plague mask, aprons, gloves, and goggles.** No part of the skin should be exposed while working with patients. I also recommend that patients are **quarantined** as soon as symptoms are detected. 

Outside of clinical environments, people can take precautions by avoiding contact with contaminated individuals. Limit time out-of-doors and in crowded areas such as marketplaces. To avoid ingesting contaminated water, drink tea or alcohol, and ensure that food is cooked thoroughly. 

##  Treatment 

At the time of writing, I have not found any treatment methods to be effective in slowing the progression of the disease. Various methods of bloodletting, including leeches, venesection, and arteriotomy, have been attempted. Now that I have worked on a sufficient sample size of patients, I can conclude with 95% confidence that **bloodletting is not an effective treatment of the plague,** although it may be effective at alleviating some discomfort from the symptoms, particularly when used to induce fainting in the early stages of the disease.

Given the lack of success in the search for a cure, I have turned my attention to methods of pain relief, which has been far more successful. Standard pain relief measures, such as laudanum, are generally useful.

Moving forward, I will be experimenting with other treatment methods in an effort both to slow/stop the disease and to alleviate patients' symptoms. 

* * *

**Footnotes**   
1The longest surviving patient whom I have treated spent 12 days in Stage 2, 19 days in Stage 3, and 13 days in Stage 4, for a total of 44 days. However, this patient was an outlier and should not be considered when calculating the amount of time a patient can expect to survive.


End file.
